You asked. We answered. We put our parkrunners’ most pressing questions to our team of experts including orthopaedic surgeons, physiotherapists and psychologists 

Q: I run seven days a week and I have constant ankle pain on the inside of my foot. I’ve changed my running style from running heel strike to running on the ball of my feet but the ache is still there each morning. What’s your advice?

A: It’s probably not good to run every day. Your body needs at least one rest day a week from running. It also sounds strange, but you don’t need to run to be able to run. You can maintain your cardio fitness just as easily with a few lengths in the pool.

Consider changing your running shoes every six months as well – the older you get, the more you might need to spend on good, supportive shoes.

If this doesn’t help, you may have plantar fasciitis (inflammation in the sole of the foot). You might then benefit from seeing a specialist. If this is the case, get in touch with Alliance Surgical, who will help you access the most appropriate specialist.

Paul Parker, Orthopaedic Surgeon, Alliance Surgical

Q: I’ve been doing really well at my 5k parkruns lately, which has tempted me to increase the distance. However, I have weak knees that are prone to injury. How do I go about training for longer-distance runs without hurting my knee even further?

A: Build up your cardiovascular fitness with gym work on a cross-trainer or a Nordic track machine. Alternate your running distances, paces and style to see what works for you. Also, think about the surface you run on – trail running is very popular on softer ground and riverside paths will be easier on the knees.

Paul Parker, Orthopaedic Surgeon, Alliance Surgical

Q: I’m fairly new to running and I get pain in my shins whenever I run. I’ve tried resting my legs for weeks, compression socks, gait analysis, new expensive trainers and more recently an osteopath, but nothing seems to work. What would you suggest?

A: It may be worth seeing an orthopaedic surgeon or physiotherapist. The pain may be caused by muscle tightness or an excessively pronated gait (that’s when you land more on the inside of your feet or tend to ‘roll-in’ at the end of your foot-strike). Avoiding hill work for a while. A good pair of anti-pronation insoles will help.

Paul Parker, Orthopaedic Surgeon, Alliance Surgical

Q: After a toe injury, I developed plantar fasciitis [pain under the heel]. The pain has prevented me from running and specifically designed insoles have not had much impact. Is there anything else I can try?

A: Before you get out of bed every morning, curl your toes up and down 10 times. Then carefully go to the top of the stairs and stand with the ball of your foot on the top step. Stretch up and down, letting your heel sink lower and lower each time. This will stretch up your Achilles tendon. You could also try an anti-inflammatory gel on the heel or arch support insoles. For really difficult cases, a Strassburg sock or a Fasciitis splint, which holds your foot at 90 degrees in bed at night, really work – you can buy them online and they don’t cost much.

Paul Parker, Orthopaedic Surgeon, Alliance Surgical

Q: I am 41 years old and after X-rays and an MRI scan I’ve been told I have osteoarthritis in my knee and should stop running. I told the doctor that I love running and don’t want to stop. Do you have any advice?

A: One good piece of advice is to think triathlon, not marathon. So, while you may have previously run five or six times a week, now try swimming twice, cycling twice and running twice each week. This will give you great all-round fitness but will not affect the knee as much. When you do run, try using an unloader brace and an anti-inflammatory gel 45 minutes before the run and then ice the knee immediately after.

Paul Parker, Orthopaedic Surgeon, Alliance Surgical

Q: I broke my fifth metatarsal [a bone on the outside of the foot] recently and I’m in a boot for about a month. How do I go about getting back to running after an injury like this?

A: Once you’re out of your splint or moon boot, think about swimming and a walk-run program to start. For example, walk 30 seconds, then run for 30 seconds. Gradually decrease the walk time and increase the run time. You can also try some vitamin D and calcium tablets from the chemist.

Paul Parker, Orthopaedic Surgeon, Alliance Surgical

Q: I recently tore the ligaments on the inside of my ankle. What’s the best thing to do so that I’m still able to run?

A: No one patient is the same and everyone’s treatment needs are different, but there are some general principles you can follow in this situation.

I’d recommend a short period of rest, dependent on the extent of your injury. A minor sprain of the ankle ligaments would mean roughly a day or two, while more severe sprains or torn ligaments may require the use of a walking boot. During this rest period, use the ICE principles: ice, compression and elevation. Ice is best used for 20 minutes every two hours, ideally applied through an elastic bandage. Elevate the ankle above the level of the heart to aid lymphatic drainage of the inflammation – try lying on the sofa with your ankle supported on the arm with pillows. Apply all three of these methods at the same time for maximum effect.

When you are able to put weight on the ankle without severe pain (there will likely be some ongoing discomfort when walking initially, but this is normal), it’s really important that you bear weight on the ankle joint as soon as possible after injury (as long as a fracture has been ruled out!) as this will encourage the chemical mediators to do their job. They will remove debris from the area and begin to lay the foundations of scar tissue that will eventually allow you to run again. The longer you leave weight bearing, the longer this healing process will take. Once in this phase you could use some supportive bandage or kinesiology tape.

Concentrate on gaining full range of movement again. This can be done while sitting – a common exercise I prescribe is to draw the alphabet with your foot.

The next stage is regaining a normal walking pattern and beginning to strengthen the muscles around the ankle. There are certain exercises that can help with this: balancing on one leg, for example.

The last stage of rehab should be about getting back to running. Plyometric exercises like jumping and landing or hopping can be useful.

How long you have been immobile for and what your baseline ability was will determine how long each of these stages lasts. Functional ability should always take priority.

Ashley James, Musculoskeletal Physiotherapist, IPRS Health

Q: I’m getting very painful calves around 2-3km into a run. Is there anything you can suggest to help stop this?

A: The likelihood is that you’re reaching your load tolerance limit at that stage. Good old-fashioned strength training might help with this. Most runners I’ve met over the years don’t have a fixed gym programme and it can be really helpful to add strengthening exercises away from running into your routine.

Focus on strengthening your calves in the gym with high-load, low-rep calf raises for improving maximum strength or some high-rep, low-load work to improve strength endurance. Both can be beneficial for runners.

Conversely, if you find that strengthening work isn’t helping, consider some new footwear. Research has suggested that the footwear you use can influence your running efficiency, which could have implications on your calves. Compression socks can also be beneficial in reducing the feeling of muscle soreness.

Ashley James, Musculoskeletal Physiotherapist, IPRS Health

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Concerned about your running technique? Our experts have the answers

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